Social work and gender::An argument for practical accounts

This article contributes to the debate on gender and social work by examining dominant approaches within the field. Anti-discriminatory, woman-centered and intersectional accounts are critiqued for reliance upon both reification and isolation of gender. Via examination of poststructural, queer and trans theories within social work, the author then presents accounts based upon structural/materialist, ethnomethodological and discursive theories, in order to open up debates about conceptualization of gender. These are used to suggest that social work should adopt a focus on gender as a practical accomplishment that occurs within various settings or contexts

Prospective observational cohort study of the association between antiplatelet therapy, bleeding and thrombosis in patients with coronary stents undergoing noncardiac surgery

Background: The perioperative management of antiplatelet therapy in noncardiac surgery patients who have undergone previous percutaneous coronary intervention (PCI) remains a dilemma. Continuing dual antiplatelet therapy (DAPT) may carry a risk of bleeding, while stopping antiplatelet therapy may increase the risk of perioperative major adverse cardiovascular events (MACE). Methods: Occurrence of Bleeding and Thrombosis during Antiplatelet Therapy In Non-Cardiac Surgery (OBTAIN) was an international prospective multicentre cohort study of perioperative antiplatelet treatment, MACE, and serious bleeding in noncardiac surgery. The incidences of MACE and bleeding were compared in patients receiving DAPT, monotherapy, and no antiplatelet therapy before surgery. Unadjusted risk ratios were calculated taking monotherapy as the baseline. The adjusted risks of bleeding and MACE were compared in patients receiving monotherapy and DAPT using propensity score matching. Results: A total of 917 patients were recruited and 847 were eligible for inclusion. Ninety-six patients received no antiplatelet therapy, 526 received monotherapy with aspirin, and 225 received DAPT. Thirty-two patients suffered MACE and 22 had bleeding. The unadjusted risk ratio for MACE in patients receiving DAPT compared with monotherapy was 1.9 (0.93–3.88), P=0.08. There was no difference in MACE between no antiplatelet treatment and monotherapy 1.03 (0.31–3.46), P=0.96. Bleeding was more frequent with DAPT 6.55 (2.3–17.96) P=0.0002. In a propensity matched analysis of 177 patients who received DAPT and 177 monotherapy patients, the risk ratio for MACE with DAPT was 1.83 (0.69–4.85), P=0.32. The risk of bleeding was significantly greater in the DAPT group 4.00 (1.15–13.93), P=0.031. Conclusions: OBTAIN showed an increased risk of bleeding with DAPT and found no evidence for protective effects of DAPT from perioperative MACE in patients who have undergone previous PCI

Sexuality and sexual identities in social work: research and reflections from women in the field

Sexuality and sexual identity have been relatively marginalized areas in both social work education and practice. However, changes in policy and legislation in the UK and other countries over the past decade have brought discussions of sexuality into the mainstream public service agenda. In social work and social care, gay and lesbian citizenship rights have been explicitly recognised. In the fields of adoption and fostering new regulations and guidance have helped improve and develop practice around assessment and intervention. It remains the case, however, that sex is often perceived as a problem area within social work and social care, discussed only in relation to sexually diverse communities or in the realm of dysfunction or pathology. This collection aims to generate a more proactive and challenging discussion of sexuality and sexual identity in social work. Its starting point is that sexuality is an essential aspect of individual identity, that users must be able to express their sexuality, and that it is essential for social workers to be able to respond and discuss sexual issues appropriately. The contributions are informed by feminist research, considering, in particular, the experiences of women working in and using social care services since the 1990s. In addition to a consideration of the wider policy, legislative and service providers' perspectives, the book includes reflective accounts as well as research-led contributions, offering a comprehensive and balanced account of this important field, which aims to inform both theory and practice